Histochemical staining used for diagnosing Hirschsprung's disease is

Correct Answer: A

Rationale: In the diagnosis of Hirschsprung's disease, histochemical staining using acetylcholine esterase is crucial. The enteric nervous system in the colon of individuals with Hirschsprung's disease lacks ganglion cells, which are responsible for releasing acetylcholine. Therefore, staining for acetylcholine esterase helps identify the absence of these cells in affected areas, confirming the diagnosis. Option B, Dopamine, is not used for diagnosing Hirschsprung's disease. Dopamine is a neurotransmitter primarily associated with the central nervous system and is not relevant to the enteric nervous system abnormalities seen in this condition. Option C, Glutamate, is also not used for diagnosing Hirschsprung's disease. Glutamate is an excitatory neurotransmitter that plays a role in various processes in the brain but is not specifically linked to the pathology of this pediatric gastrointestinal disorder. Option D, Chromogranin and synaptophysin, are markers used in neuroendocrine tumors and are not typically employed in the diagnosis of Hirschsprung's disease, which primarily involves abnormalities in the enteric nervous system in the colon. Understanding the specific staining techniques and markers used in the diagnosis of various conditions is essential for healthcare professionals, especially in specialties like pediatric nursing where early and accurate diagnosis is critical for providing appropriate care and interventions.

Correct Answer: D

Rationale: In this question, the incorrect statement regarding shock is option D: "In hypovolemic shock mean arterial pressure is normal." The correct answer is D because in hypovolemic shock, there is a decrease in blood volume leading to a decrease in cardiac output, which subsequently results in a decrease in mean arterial pressure. This decrease in mean arterial pressure is a key characteristic of hypovolemic shock. Option A is incorrect because in cardiogenic shock, systemic vascular resistance is typically low due to decreased cardiac output. Option B is incorrect because in hypovolemic shock, the pulmonary capillary wedge pressure is typically elevated as the body tries to compensate for the reduced blood volume. Option C is incorrect because in distributive shock, such as septic shock, central venous pressure is usually decreased due to vasodilation and pooling of blood in the periphery. Understanding the differences in the hemodynamic parameters in different types of shock is crucial for healthcare professionals, especially in the field of pediatrics where shock can have rapid and severe consequences. It is important to recognize these differences to provide appropriate and timely interventions to stabilize pediatric patients in shock.

Correct Answer: D

Rationale: Rationale: 22q11 deletion syndrome, also known as DiGeorge syndrome, is commonly associated with congenital heart defects. The correct answer, D) D-Transposition of great arteries, is not typically associated with 22q11 deletion syndrome. This is because 22q11 deletion syndrome is more commonly linked to conotruncal defects such as Tetralogy of Fallot, Truncus arteriosus, and Interrupted aortic arch. Tetralogy of Fallot is characterized by four heart defects, including a ventricular septal defect and overriding aorta, which are commonly seen in patients with 22q11 deletion. Truncus arteriosus is a condition where a single blood vessel comes out of the heart, which is also associated with 22q11 deletion. Interrupted aortic arch is a rare heart defect where the aorta is not fully developed, and it is another condition commonly found in individuals with 22q11 deletion syndrome. In an educational context, understanding these associations is crucial for healthcare professionals, especially nurses, who care for pediatric patients with congenital heart conditions. Recognizing patterns of congenital anomalies can aid in early diagnosis, appropriate management, and genetic counseling for families affected by 22q11 deletion syndrome. This knowledge plays a vital role in providing holistic care to pediatric patients with complex medical needs.

Correct Answer: D

Rationale: In the context of pediatric cardiovascular conditions, understanding the concept of admixture lesions is crucial for nursing professionals. An admixture lesion arises when there is mixing of oxygenated and deoxygenated blood due to structural defects in the heart. In this question, "Pulmonary atresia with intact ventricular septum" is not an admixture lesion because it involves a complete blockage at the pulmonary valve, preventing blood flow to the lungs. This condition results in deoxygenated blood being unable to reach the lungs for oxygenation, without mixing with oxygenated blood. On the other hand, the other options listed - Transposition of great arteries, Truncus arteriosus, and Total anomalous pulmonary venous connection - all involve structural abnormalities leading to mixing of oxygenated and deoxygenated blood within the heart, thus representing admixture lesions. For nursing professionals, recognizing and understanding these distinctions is essential for providing appropriate care, monitoring for complications, and educating patients and families about these complex conditions. By grasping these concepts, nurses can effectively contribute to the holistic care of pediatric patients with cardiovascular conditions.

Correct Answer: A

Rationale: In pharmacology, understanding the effects of medications on physiological parameters like heart rate is crucial. In this case, beta blockers are known to lower heart rate by blocking the action of adrenaline on beta receptors. This results in a reduced heart rate response to exercise or stress. For age-predicted maximum heart rate, the commonly used formula is 220 - age. For a 60-year-old man, this would be 220 - 60 = 160 beats per minute. However, beta blockers can lower the maximum heart rate by around 10-20 beats per minute. Therefore, the age-predicted maximum heart rate for a 60-year-old man on beta blockers would be slightly lower, around 150-140 beats per minute. Looking at the options provided: A) 122 - This is the closest to the adjusted age-predicted maximum heart rate for a 60-year-old man on beta blockers. B) 133 - This is higher than expected for a man on beta blockers. C) 155 - This is closer to the normal age-predicted maximum heart rate without beta blockers. D) 166 - This is significantly higher than expected for a man on beta blockers. Understanding these concepts is vital for healthcare providers, especially in pediatrics, where medication dosages are often adjusted based on individual patient factors like age and comorbidities. By grasping the effects of medications like beta blockers on heart rate, nurses can better monitor and manage pediatric patients with cardiovascular conditions.